A comparative study of two full-endoscopic foraminoplasty techniques for lumbar disc herniation.

IF 2.7 3区 医学 Q2 CLINICAL NEUROLOGY European Spine Journal Pub Date : 2025-03-01 Epub Date: 2025-01-15 DOI:10.1007/s00586-025-08662-x
Hengrui Chang, Yuanqing Niu, Yiwen Zhang, Ao Yang, Zhenguo Shang, Di Zhang, Jiaxin Xu
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Abstract

Objective: This study aimed to compare the use of the endoscopic drill (ED) with the extra-endoscopic trephine (EET) in treating lumbar disc herniations with regard to efficiency, safety, and clinical outcomes.

Methods: From January 2022 and June 2023, 136 patients who had the single-level LDH and received the transforaminal endoscopic surgery were divided into two groups according to the foraminoplasty technique: the EET group (n = 69) and the ED group (n = 67). Surgery-related parameters, complications, Visual Analogue Scale (VAS, 0-10), and Oswestry Disability Index (ODI, 0-100%) were assessed and compared among two groups.

Results: The mean operation time and the foraminoplasty time of the EET group was significantly shorter than that of the ED group (P < 0.05). Patients in ED group reported less back pain on the VAS during foraminoplasty than EET group. Although the total complication rate was similar between two groups, the incidence of neural irritation in ED group was significantly lower than that in the EET group. There were no significant differences in VAS or ODI scores at each follow-up visit between two groups.

Conclusions: The application of EET and ED were both effective for full-endoscopic foraminoplasty, and have achieved good clinical outcomes. Although the efficiency of EET is higher than that of ED, it faces some problems during use, such as a high risk of neural irritation, intense intraoperative pain, and the trephine displacement. The ED technique is safe and controllable, which can be used as an ideal method for supplementary foraminoplasty.

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两种全内窥镜椎间孔成形术治疗腰椎间盘突出症的比较研究。
目的:本研究旨在比较内窥镜钻孔(ED)与内窥镜外环钻(EET)治疗腰椎间盘突出症的有效性、安全性和临床结果。方法:选取2022年1月至2023年6月行椎间孔内窥镜手术的单节段LDH患者136例,根据椎间孔成形术的不同分为EET组(n = 69)和ED组(n = 67)。对两组手术相关参数、并发症、视觉模拟评分(VAS, 0-10)和Oswestry残疾指数(ODI, 0-100%)进行评估和比较。结果:EET组的平均手术时间和椎间孔成形术时间明显短于ED组(P)。结论:应用EET和ED进行全内镜椎间孔成形术均有效,取得了良好的临床效果。虽然EET的效率高于ED,但在使用过程中存在神经刺激风险高、术中疼痛剧烈、套管移位等问题。该技术安全、可控,是一种理想的补椎间孔成形术。
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来源期刊
European Spine Journal
European Spine Journal 医学-临床神经学
CiteScore
4.80
自引率
10.70%
发文量
373
审稿时长
2-4 weeks
期刊介绍: "European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts. Official publication of EUROSPINE, The Spine Society of Europe
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